GIRL SCOUT MISSION Adult Membership Girl Scouting builds girls of courage, Join the global network of 2.6 million Girl Scouts confidence, and character, who Membership year through 9/30/2019 make the world a better place. Register online today at www.girlscouts-swtx.org MEMBERSHIP OPTIONS Check one: � New Member � Renewing Member � Lifetime Member � Troop # Fees are not refundable or Title or salutation: � Mrs. � Ms. � Miss � Mr. � Dr. � Other: transferable to another person. Annual Membership � Annual fee: $25 Name: First Middle Last Lifetime Membership � One-time fee of $400 Address Apartment Adult 18 years or older who is not a former girl member or former girl member who is City State Zip Code 30 years or older. () () Young Alumnae Home Phone Business Phone Lifetime Membership ( ) � One-time fee of $200 Cell Phone Email Address Former girl member who is 18-29 years old. Active Military Retired Military | Branch: CONTACT INFORMATION CONTACT New Members Only Employer Title/Occupation � Extended year: $35 I wish to opt out: �Texts Available for purchase between May 1 and � Emails By signing here and checking the circle to the left, each signee (and on behalf of the girl, as Sept 20, 2018. Membership will be valid applicable) agrees to receive auto dialed informational or marketing text messages at the cell until September 20, 2019. number above, understanding such consent is not required to join. YES! I would also like to make a Girl Scouts respects and welcomes Gender: Number of years in Date of birth: donation today that directly benefits girls in Girl Scouts of Southwest Texas council people from all backgrounds � Female Girl Scouting: / / area. Enclosed is my tax-deductible and abilities. By completing the mm dd yyyy � Male As a girl: donation. following information (as defined by the U.S. Census Bureau), you ensure As an adult: Check one: support and funding for girls in I am (Check all that apply): I am Hispanic or Latina: � $500 � $250 � $150 your community. Hispanic/Latina � American Indian � White � Yes is defined as an ethnicity, not a or Alaskan Native � Other (Please specify) � No � $100 � $50 � $25 DEMOGRAPHICS race, therefore reported separately. � Asian � I choose not to share � Other: $ This information is used for � Black or African American � I choose not to share at this time. PAYMENT INFORMATION statistical purposes only. � Hawaiian or Pacific Islander at this time. Annual Membership: $
I will be participating in Girl Scouting as I would like to participate in � Community Volunteer Lifetime Membership: $ (Check all that apply): the following role(s): � Gamma Sigma Advisor � Co-Leader Young Alumnae � Volunteer—I am/will be volunteering for Girl Scouts. � Board Member Lifetime Membership: $ � Parent/family—I am a parent/guardian/family member of a Girl Scout. � Troop Helper � Adult Member** Extended Year Fee: $ � Girl Scout alumna—I was a Girl Scout, either as a girl, adult, or both. � Troop Money Mgr. other: � Troop Nut Mgr. **Adult members hold no position � Staff—I am/will be employed by Girl Scouts. in the troop. This position is used to Donation: $ PARTICIPATION � Troop Cookie Mgr. clearly indicate to co-leaders that this � Community partner adult member does not have a criminal background check (CBC) and cannot be Total Attached: $ � Troop First Aid/CPR Mgr. involved with troop meetings and events � Other where a criminal background check is � Troop Camp Certified Mgr. required. � Cash � Check* � Amex � Discover Media Permission The Girl Scout Promise The Girl Scout Law When participating in Girl Scout activities, I (or the On my honor, I will try: I will do my best to be � Visa � MasterCard person I am registering) give consent to be To serve God and my country, honest and fair, � Other interviewed, photographed, videotaped, or To help people at all times, friendly and helpful, electronically imaged for the purposes of promotional And to live by the Girl Scout Law. considerate and caring, materials, news releases, or other published formats courageous and strong, and Name on Credit Card for either the local Girl Scout council or Girl Scouts of When making the Girl Scout Promise, responsible for what I say and do, the USA. The images will be the sole property of the individual members may substitute and to Credit Card # local Girl Scout council or Girl Scouts of the USA. I wording appropriate to their own spiritual respect myself and others, hereby release and hold harmless the local Girl Scout beliefs for the word “God.” respect authority, council and Girl Scouts of the USA from any claim use resources wisely, Expiration Date CVV Code arising from the use of these images. make the world a better place, and ACCEPTANCE be a sister to every Girl Scout. Signature � I wish to opt out at this time.
Date I accept and abide by the Girl Scout Promise and Law: *Make checks payable to Girl Scouts.
Return this registration form, along with the applicable GSUSA membership fee, to Signature Date your local council.
Council Code: Community: Troop: USE
ADMIN THANK YOU FOR SUPPORTING GIRL SCOUTS! Please return this completed form with payment to one of the following: Email: [email protected] | Fax: 210.349.2666 | Mail: ATTN: Customer Care: 811 N Coker Loop, San Antonio, TX 78216 Receipt #: ______MFA20190318